WIP 50 - A retrospective study of premature infants' growth velocities when supplemented with oral sodium chloride compared to those without sodium chloride supplementation in the Neonatal Intensive Care Unit

Publication Number: WIP 50.7581

Kenna Leethy, Phoenix Children's Hospital, Scottsdale, AZ, United States; Jason Couch, Creighton University School of Medicine, Phoenix, AZ, United States; Lindsey Ernst, Creighton University School of Medicine, Phoenix, AZ, United States

Background: Nutritional status impacts short- and long-term health outcomes, especially in preterm infants. Growth failure is a significant problem facing NICU patients by suboptimal sodium intake. Research indicates that human milk may lack sufficient sodium to meet the needs of preterm infants. Current AAP guidelines suggest 3-5 mEq/kg/day of sodium intake whereas ESPGHAN recommend an upper limit of 8 mEq/kg/day of sodium. The recommendation is based on evidence that sodium deficiency may contribute to growth failure in preterm infants. In 2022, our NICU implemented guidelines to identify infants who may benefit from sodium chloride supplementation using the University of Iowa’s recommendations for measuring urine sodium. The goal of this study is to understand whether growth velocities have been improved by targeted oral NaCl solution.

Objective: The objective of this study is to describe and evaluate the relationship between growth velocity and initiation of sodium chloride supplementation at 2 weeks of age for infants born before 30-weeks gestation admitted to the NICU.

Design/Methods: This is a retrospective chart review to determine the relationship between infant growth and sodium chloride supplementation utilizing weight Z-scores. Infants will be categorized by those who received sodium chloride supplementation based on serum values compared to those who received supplementation based on urine sodium values. The two groups will then be compared to an age-matched group that did not receive any sodium chloride supplementation using ANOVA statistical test. Infants will be classified into growth categories based on the change in weight-for-age Z-scores from birth to discharge. IRB approval was obtained June 2024. Chart review is currently in process and all data is being uploaded into Redcap. Data collection will be complete and data analysis will begin December 1, 2024.